RT Journal Article
SR Electronic
T1 Diabetes screening after gestational diabetes in England: a quantitative retrospective cohort study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e17
OP e23
DO 10.3399/bjgp14X676410
VO 64
IS 618
A1 McGovern, Andrew
A1 Butler, Lucilla
A1 Jones, Simon
A1 van Vlymen, Jeremy
A1 Sadek, Khaled
A1 Munro, Neil
A1 Carr, Helen
A1 de Lusignan, Simon
YR 2014
UL https://bjgp.org/content/64/618/e17.abstract
AB Background The National Institute for Health and Care Excellence (NICE) recommends postpartum and annual monitoring for diabetes for females who have had a diagnosis of gestational diabetes mellitus (GDM). Aim To describe the current state of follow-up after GDM in primary care, in England. Design and setting A retrospective cohort study in 127 primary care practices. The total population analysed comprised 473 772 females, of whom 2016 had a diagnosis of GDM. Method Two subgroups of females were analysed using electronic general practice records. In the first group of females (n = 788) the quality of postpartum follow-up was assessed during a 6-month period. The quality of long-term annual follow-up was assessed in a second group of females (n = 718), over a 5-year period. The two outcome measures were blood glucose testing performed within 6 months postpartum (first group) and blood glucose testing performed annually (second group). Results Postpartum follow-up was performed in 146 (18.5%) females within 6 months of delivery. Annual rates of long-term follow-up stayed consistently around 20% a year. Publication of the Diabetes in Pregnancy NICE guidelines, in 2008, had no effect on long-term screening rates. Substantial regional differences were identified among rates of follow-up. Conclusion Monitoring of females after GDM is markedly suboptimal despite current recommendations.